MEDICARE: PRISM DISTRIBUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1437013174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRISM DISTRIBUTIONS LLC

Provider Business Mailing Address
First Line	:	1396 BRAMLETT FOREST CT
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-2687
Country	:	US
Telephone Number	:	346-466-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1396 BRAMLETT FOREST CT
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-2687
Country	:	US
Telephone Number	:	346-466-5298
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SHAHBAZ ASLAM
Credential	:
Telephone Number	:	346-466-5298

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “PRISM DISTRIBUTIONS LLC ” Practice Location

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